Kat Sweet, Sports Medicine

When a Cyclist Needs a Helping Hand

"I've been riding mountain bikes since 1987. My dad bought me my first mountain bike. I've always loved getting out on the trails, challenging myself. There's an element of risk that is exciting," she says.

A professional cycling coach and a competitive mountain biker, Kat is the owner of Sweetlines, a business that aims to make mountain biking accessible, fun and, most of all, safe for women and children.

So safety was on Kat's mind one evening in January 2013 when she suddenly collided with another biker and nearly ended her cycling career.

"I'm really cautious in my sport. I take risks, but I'm careful about it. In 26 years of mountain biking, this was the first real, serious injury I had," Kat says.

The accident happened in Portland at an indoor cycling event. Kat wasn't a participant — she had organized the event and was coaching the cyclists. That evening, she decided to go for a ride on the track, just for fun.

"I made a mistake. I followed someone too closely on the track. She went the wrong way and suddenly my front wheel slammed into her. I was up in the air, then I hit the ground. I felt my right arm just crumple under me."

The other rider was OK, but when Kat sat up, her wrist was crooked and her elbow hurt terribly. An ambulance arrived and took her to a nearby hospital. After being X-rayed, Kat learned that though she was wearing protective gear, she had dislocated and fractured her elbow, shattered her radius (the large bone in the forearm that reaches from the thumb-side of the wrist to the elbow) and dislocated her ulna (the other large bone in the forearm, which reaches from the little-finger side of the wrist to the elbow). A doctor set her dislocations and put a soft cast on her arm.

Kat's fellow coaches pulled together to make the event a success and she returned to watch the cyclists compete the next day. "I don't think anyone realized how hurt I was," she recalls.

Even Kat didn't know the full extent of her injuries, or what it would take to get her arm working like it had before.

After a friend drove her home to Seattle, Kat made an appointment with Dr. Sarah Beshlian, a hand surgeon at Northwest Hospital and part of the UW Medicine Hand, Elbow, Shoulder Center. The center, which has four locations including Northwest Hospital, treats a wide range of conditions including fractures, repetitive stress injuries, arthritis, tendon and ligament injuries, and nerve issues.

"It was a terrible injury. She not only had a severe fracture of the wrist, she also had an elbow dislocation. It was like something you'd see from a car accident," says Dr. Beshlian. "The doctor at the hospital in Portland performed an initial treatment, but it was obvious when she came to see me that she needed surgery."

"I was super nervous. I'd never had surgery before," Kat recalls.
"

My concern for her was the high level of use that she needed from that arm for her mountain biking. She had to have a really good outcome from the surgery," says Dr. Beshlian.

Dr. Beshlian performed a two-and-a-half hour surgery on Kat's injured arm, reassembling the little pieces of broken bone and using two metal plates and seven screws to hold Kat's wrist together, as well as cadaver bone, which is used to fill in the gaps between the ends of a bone that has been fractured too severely to be reconnected. After the surgery, Dr. Kevin Smith from The Sports Medicine Clinic at Northwest Hospital treated Kat's elbow dislocation, which fortunately did not require surgery.

As soon as the surgery was over, Kat began thinking about getting back on her bike.

"Dr. Beshlian was really sympathetic about me being a professional athlete. I told her, ‘I need to start working out as soon as possible.' So she put me in a splint rather than a hard cast so that it would be easier for me to exercise," Kat says.

Kat took about three weeks to rest and heal her arm, then began physical therapy earlier than is typical, since she didn't want her arm to get stiff or the muscles to atrophy.

She also received hand therapy at Northwest Hospital.

"In the last year, hand surgery has expanded a lot at Northwest Hospital. We've also expanded our hand therapy program. So much of the success in hand surgery depends on the patient getting rehabilitation with hand therapy," explains Dr. Beshlian.

Hand therapy initially involves teaching patients to care for their wounds and any scars, then helping them restore their range of motion and strength through simple exercises. In addition to fractures and dislocations like Kat's, hand therapy also treats conditions such as tendonitis, carpal tunnel syndrome, arthritis and inflammatory disorders, and problems caused by neurologic conditions such as strokes.

"Hand surgery is not all about operations. My goal is to get people back to good function and give them relief from pain," says Dr. Beshlian.

Kat had to work hard to be able to use her hand for everyday activities, much less get back on mountain trails.

"It was incredibly painful, but I knew I had to do it to get back on my bike," she says. "Within two weeks, I was back in the gym doing light workouts. Within two months, I was back on a street bike. In three months, I was mountain biking again. Within four months of the accident, I was doing small jumps on my bike, and at the six month mark, I was downhilling and doing big jumps."

Eight months after her injury, Kat returned to competition.

"It was great to be back out there. I didn't do as well as I used to, but I know I have to give myself time to get it all back," she says.

"After an injury like this, her arm will never be 100 percent like it was. But she's functioning at 90 to 95 percent already, less than a year after the injury. That's pretty impressive," says Dr. Beshlian.

Kat has found a silver lining to her injury.

"Now as a coach, I'm much more empathetic about the healing process if one of my students gets hurt. It's made me a much stronger person in the long run," she says.

Kat also has an important message for anyone who finds themselves injured and unable to do something they love.

"Don't give up. Give yourself time to heal. It's not an easy process, but keep persevering. My wrist will never be the same, but I'm doing the same things I did before the accident. I love my sport. It's my way of making a difference in the world."

For more information about UW Medicine Hand, Elbow, Shoulder Center or to make an appointment, call 206.520.5000.

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